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Type I Diabetes and Kidney
          Disease




                        Robyn Eady
                            Eng/215
                  Strayer University
Overview
o Research Proposal to compare Type 1 Diabetes and Chronic
  Kidney Disease with Long-Term complications. What do they
  have in common? Can it be reversed?
   o What is Diabetes
   o What is Chronic Kidney Disease
o Literature Review
   o Review some of the facts and information about Diabetes
     and its development of type 1
   o Chronic Kidney Disease and Diet
o Hypothesis
Overview Cont.
o Method
   o Participants
   o Materials
   o Procedures

o References
What is Diabetes?
Diabetes is a disease in which the blood glucose levels
are above normal this happens when most of the food he
or she eat is turned into glucose, or sugar, for our bodies
to use for energy.

The pancreas, is an organ that lies near the stomach, and
makes a hormone called insulin to help glucose get into
the cells of our bodies. When a person has diabetes, the
body either doesn’t make enough insulin or can’t use its
own insulin as well as it should. This will cause sugar to
build up in your blood.

Diabetes can cause serious health complications including
heart disease, blindness, kidney failure and lower
extremity amputations.

                           www.cdc.gov/diabetes/consumer/learn/htm   4
Literature Review
o Development of Type 1 Diabetes
   o Types of Diabetes
      o Type 1
      o Type 2
      o Gestational Diabetes
o Growing Epidemics
o Symptoms of Diabetes
   o Treatment with Insulin and Medication
   o Long-Term Complications
   o Diabetes: Harm the Kidneys
Development of Type I Diabetes




                                                 6
                 http://emedicine.medsacpe.com
Types of Diabetes
 Type 1 – Insulin dependent, persons with Type 1 must have
  insulin delivered by injections or pump.

 Type 2 – Non-Insulin dependent or adult-onset diabetes.
    Associated with older age
    Obesity
    Family history of diabetes
    History of gestational diabetes, physical inactivity
    Race/ethnicity
       o (African American and Native Hawaiian, and other
          Pacific Islanders are higher risk for Type 2 diabetes
          and complications.

 Gestational – occurs in women who are pregnant, late stage.


                     www.cdc.gov/diabetes/pubs/general07.htm      7
Diabetes: Growing Epidemic
Did you know these facts about diabetes?
     Nearly 21 millions people in the United
      States (about 7% of the populations) have
      diabetes, and about a third do not even know
      they have the disease.
     Diabetes is the leading cause of chronic
      kidney disease.
     Diabetes accounts for 45% of kidney failure.
     Worldwide, 171 million people have
      diabetes.
     At lease 20% of people older than 65 years
      have diabetes.
                      www.kidney.org                 8
Symptoms of Diabetes
 Frequent Urination
 Excessive Thirst
 Unexplained Weight Loss
 Extreme Hunger
 Sudden Vision Changes
 Tingling or Numbness in hands or feet
 Feeling very tired much of the time
 Very dry skin
 Sores that are slow to heal
 More infections than usual
           Nausea, vomiting, or stomach pains are some of the
           symptoms in an insulin-dependent diabetic, which is called
           Type 1 Diabetes.                                             9
               www.cdc.gov/diabetes/consumer/learn.htm
Risk Factors & White Foods to Avoid
 Risk Factors          White Foods to Avoid
Belly Fat              Bread “White”
Family History         Flour “White”
Smoking                Sugar “White”
Sanitary Life Style    Fried Foods
                        Pasta “White”
                        Soda
Treatment with Insulin & Oral Medication
                                       Insulin
                                        14%


                                                    No
                                                 Medication
                                                   16%
     Oral Only
       57%


                                             Insulin &
                                               Oral
                                            Medication
                                               13%



                 www.cdc.gov/diabetes/pubs/general07.htm      11
Long-Term Complications
                           Heart
                           Failure


             Angina                       Stroke




                        Heart, Brain,
        Skin            Legs, Eyes,                  Leg
     Breakdown            Kidney                   Cramps
                        Nerves, Skin
                             s




           Damage to
                                        Poor Vision
           the Nerves

                          Kidney
                          Failure




             www.merck.com/mmhe                             12
Diabetes and the Kidneys
Diabetes can harm the kidneys by causing damage to the
following:
             Blood vessels in the kidneys
             Poor intake of fluid
             Nerves in your body
             Medication – diuretic “water pills”
             Urinary tract

                       www.kidney.org                13
Functions of the Kidney

Pair of Organs


Keep the Blood
    Clean

Process 200
  quarts of
Blood daily.

  Removes
   Waste




                 www.niddk.org   14
Symptoms of Chronic Kidney Disease
                                        Frequent Urination
                                    Blood and or Protein in the
                                              Urine
                                     Burning during Urination
                                       Puffiness & Swelling
                                    (edema) in the face, hands
                                              & feet
                                        High Blood Pressure
                                            Skin Itching
                                        Nausea & Vomiting
                                             Weakness




         www.brighthub.com/health/diabetes/articles/2749/aspx     15
Primary Causes of Kidney Failure
     Glomerulonep            Kidney Failure
         hritis                                       Cystics
          8%                                          Disease
                                                        2%          Urologic
                                                                    Disease
                                                                      2%

       High Blood
        Pressure
          27%                                                   Other
                                                                17%




              Diabetes
                44%


                    kidney.niddk.nih.gov/kudisease/pubs/kdd                    16
Stages of Chronic Kidney Disease
                                              Glomerular Filtration
    Stage   Description                       Rate (GFR)
            Kidney damage (e.g.,
            protein in the urine)
    1       w/normal GFR                      90 or above

            Kidney damage w/mild
    2       decrease in GFR                   60 to 89


    3       Moderate decrease in GFR          30 to 59


    4       Severe reduction in GFR           15 to 29
                                                                      Dialysis



    5       Kidney Failure                    Less than 15
                                                                         17
                             www.kidney.org
Prevent Kidney Disease
Ways that diabetics can prevent themselves from
acquiring kidney disease:
        Control your blood sugar level
        Keep blood pressure under control
        Check your blood pressure often
        Test for kidney disease once a year
       Take medicine to control blood glucose
         cholesterol, & blood pressure.
        Follow your diet for diabetes
        Get regular exercise                     18
                www.kidney.org
Chronic Kidney Disease
                 Changing the Diet
Protein
   Limit the amount of protein that you eat: instead of 8 oz.
    more like 3 or 4oz.
Cholesterol
   Limit the amount of High Cholesterol foods:
    cookies, pastries and muffins.
Sodium
   No canned or processed foods like: frozen dinners and hot
    dogs.
Potassium
   Oranges, potatoes, bananas, dried fruits, dried beans, and
    peas, nuts and snack foods.
Not Smoking
             Two leading cause of Kidney Disease is
              Diabetes and High blood pressure
                                                                 19
                 www.kidney.niddk.nih.gov
Sample Meal Plan
         Diabetes and Kidney Disease
Breakfast
    o Peanut Butter Oatmeal
    o Fresh Sliced Pears
    o Very Berry Smoothie
Lunch
    o Baked Salmon on a Toasted Hamburger Bun
    o Roasted Asparagus Spears w/Spicy Tofu Hollandaise
    o Sliced Pineapple w/Strawberry Lemon thyme Sorbet
Snack
    o Cucumbers w/Horseradish & Dill Dip
    o Mixed Nuts
Dinner
    o Grilled Vegetables on Bulgur Pilaf
    o Sliced Avocado
    o Rum-Baked Apples
          The potassium contents of this meal may be to high for some people
                      with Chronic Kidney Disease stages 3 or 4

                  www.kidney.niddk.nih.gov                                     20
Hypothesis
It is hypothesized individuals with stages 3 or 4 chronic
kidney disease who consume a Renal Failure Diet over a 6
month period will be significantly more likely to have their
chronic kidney disease enter remission than individuals with
stage 3 or 4 chronic kidney disease who do not modify their
diets.

It is further hypothesized that individuals with stage 3 or 4
chronic kidney disease who consume an renal failure diet over
a 6 month period will be significantly less likely to require
dialysis treatment than individuals with stage 3 or 4 chronic
kidney disease who do not modify their diets.

                                                               21
Method
Participants




 www.kidney.niddk.nih.gov   23
Materials




www.kidney.niddk.nih.gov   24
Materials



               Renal       Blood –      10      Outpatient
Assessment
               Failure     Testing    Medical    Dialysis
 Materials
             Diet Foods   Equipment   Doctors    Facility
Procedures
 Diagnosis of Type I Diabetes and participants with stage
 3 or 4 Chronic Kidney Disease.
Experimental participants receive a week’s worth of
 Renal Failure Diet frozen meals from the Outpatient
 Dialysis Center weekly.
 Control participants will maintain their regular diet;
 which will consist of all food being:

        Broiled
        Grilled
        Baked
                                                                 26

                                               www.kidney.niddk.nih.gov
Procedures Cont.
 Participants will be asked to eat meals at a set times.
       7 am Breakfast
       11 am Lunch
        2:30pm Snack
     6 pm Dinner
 Time Frame
       6 month period
 Assessments to determine the necessity of dialysis
 treatment
References
American Diabetes Association, (2007); Diabetes, Retrieved on
        August 12, 2010, from www.diabetes.org

Brighthub Health (2008); Health and Diabetes, Retrieved on    August
        25, 2010; from;
        www.brighthub.com/health/diabetes/articles/2749/apsx

Center for Disease Control, (2007); What is diabetes, Retrieved
        on August 12, 2010, from
        www.cdc.gov/diabetes/consumers/learn.htm

eMedicine for WebMD, (2009); Development of Type I
        Diabetes; Retrieved from http://emedicine.medscape.com
References
Merck Manuals, (2010); Online Medical Library, Long-Term
        Complications Diabetes; Retrieved on August 19, 2010,
        from www.merck.com/mmhe

National Kidney and Urologic Disease Information Clearinghouse,
        (2010); Kidney Disease, Retrieved from,
        www.kidney.niddk.nih.gov

National Kidney Foundation, (2008); Kidney Disease and
        Diabetes, Retrieved on August 19, 2010, from
        www.kidney.org

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Diabetes Presentation

  • 1. Type I Diabetes and Kidney Disease Robyn Eady Eng/215 Strayer University
  • 2. Overview o Research Proposal to compare Type 1 Diabetes and Chronic Kidney Disease with Long-Term complications. What do they have in common? Can it be reversed? o What is Diabetes o What is Chronic Kidney Disease o Literature Review o Review some of the facts and information about Diabetes and its development of type 1 o Chronic Kidney Disease and Diet o Hypothesis
  • 3. Overview Cont. o Method o Participants o Materials o Procedures o References
  • 4. What is Diabetes? Diabetes is a disease in which the blood glucose levels are above normal this happens when most of the food he or she eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, is an organ that lies near the stomach, and makes a hormone called insulin to help glucose get into the cells of our bodies. When a person has diabetes, the body either doesn’t make enough insulin or can’t use its own insulin as well as it should. This will cause sugar to build up in your blood. Diabetes can cause serious health complications including heart disease, blindness, kidney failure and lower extremity amputations. www.cdc.gov/diabetes/consumer/learn/htm 4
  • 5. Literature Review o Development of Type 1 Diabetes o Types of Diabetes o Type 1 o Type 2 o Gestational Diabetes o Growing Epidemics o Symptoms of Diabetes o Treatment with Insulin and Medication o Long-Term Complications o Diabetes: Harm the Kidneys
  • 6. Development of Type I Diabetes 6 http://emedicine.medsacpe.com
  • 7. Types of Diabetes  Type 1 – Insulin dependent, persons with Type 1 must have insulin delivered by injections or pump.  Type 2 – Non-Insulin dependent or adult-onset diabetes.  Associated with older age  Obesity  Family history of diabetes  History of gestational diabetes, physical inactivity  Race/ethnicity o (African American and Native Hawaiian, and other Pacific Islanders are higher risk for Type 2 diabetes and complications.  Gestational – occurs in women who are pregnant, late stage. www.cdc.gov/diabetes/pubs/general07.htm 7
  • 8. Diabetes: Growing Epidemic Did you know these facts about diabetes? Nearly 21 millions people in the United States (about 7% of the populations) have diabetes, and about a third do not even know they have the disease. Diabetes is the leading cause of chronic kidney disease. Diabetes accounts for 45% of kidney failure. Worldwide, 171 million people have diabetes. At lease 20% of people older than 65 years have diabetes. www.kidney.org 8
  • 9. Symptoms of Diabetes  Frequent Urination  Excessive Thirst  Unexplained Weight Loss  Extreme Hunger  Sudden Vision Changes  Tingling or Numbness in hands or feet  Feeling very tired much of the time  Very dry skin  Sores that are slow to heal  More infections than usual Nausea, vomiting, or stomach pains are some of the symptoms in an insulin-dependent diabetic, which is called Type 1 Diabetes. 9 www.cdc.gov/diabetes/consumer/learn.htm
  • 10. Risk Factors & White Foods to Avoid Risk Factors White Foods to Avoid Belly Fat Bread “White” Family History Flour “White” Smoking Sugar “White” Sanitary Life Style Fried Foods Pasta “White” Soda
  • 11. Treatment with Insulin & Oral Medication Insulin 14% No Medication 16% Oral Only 57% Insulin & Oral Medication 13% www.cdc.gov/diabetes/pubs/general07.htm 11
  • 12. Long-Term Complications Heart Failure Angina Stroke Heart, Brain, Skin Legs, Eyes, Leg Breakdown Kidney Cramps Nerves, Skin s Damage to Poor Vision the Nerves Kidney Failure www.merck.com/mmhe 12
  • 13. Diabetes and the Kidneys Diabetes can harm the kidneys by causing damage to the following:  Blood vessels in the kidneys  Poor intake of fluid  Nerves in your body  Medication – diuretic “water pills”  Urinary tract www.kidney.org 13
  • 14. Functions of the Kidney Pair of Organs Keep the Blood Clean Process 200 quarts of Blood daily. Removes Waste www.niddk.org 14
  • 15. Symptoms of Chronic Kidney Disease Frequent Urination Blood and or Protein in the Urine Burning during Urination Puffiness & Swelling (edema) in the face, hands & feet High Blood Pressure Skin Itching Nausea & Vomiting Weakness www.brighthub.com/health/diabetes/articles/2749/aspx 15
  • 16. Primary Causes of Kidney Failure Glomerulonep Kidney Failure hritis Cystics 8% Disease 2% Urologic Disease 2% High Blood Pressure 27% Other 17% Diabetes 44% kidney.niddk.nih.gov/kudisease/pubs/kdd 16
  • 17. Stages of Chronic Kidney Disease Glomerular Filtration Stage Description Rate (GFR) Kidney damage (e.g., protein in the urine) 1 w/normal GFR 90 or above Kidney damage w/mild 2 decrease in GFR 60 to 89 3 Moderate decrease in GFR 30 to 59 4 Severe reduction in GFR 15 to 29 Dialysis 5 Kidney Failure Less than 15 17 www.kidney.org
  • 18. Prevent Kidney Disease Ways that diabetics can prevent themselves from acquiring kidney disease:  Control your blood sugar level  Keep blood pressure under control  Check your blood pressure often  Test for kidney disease once a year Take medicine to control blood glucose cholesterol, & blood pressure.  Follow your diet for diabetes  Get regular exercise 18 www.kidney.org
  • 19. Chronic Kidney Disease Changing the Diet Protein  Limit the amount of protein that you eat: instead of 8 oz. more like 3 or 4oz. Cholesterol  Limit the amount of High Cholesterol foods: cookies, pastries and muffins. Sodium  No canned or processed foods like: frozen dinners and hot dogs. Potassium  Oranges, potatoes, bananas, dried fruits, dried beans, and peas, nuts and snack foods. Not Smoking  Two leading cause of Kidney Disease is Diabetes and High blood pressure 19 www.kidney.niddk.nih.gov
  • 20. Sample Meal Plan Diabetes and Kidney Disease Breakfast o Peanut Butter Oatmeal o Fresh Sliced Pears o Very Berry Smoothie Lunch o Baked Salmon on a Toasted Hamburger Bun o Roasted Asparagus Spears w/Spicy Tofu Hollandaise o Sliced Pineapple w/Strawberry Lemon thyme Sorbet Snack o Cucumbers w/Horseradish & Dill Dip o Mixed Nuts Dinner o Grilled Vegetables on Bulgur Pilaf o Sliced Avocado o Rum-Baked Apples The potassium contents of this meal may be to high for some people with Chronic Kidney Disease stages 3 or 4 www.kidney.niddk.nih.gov 20
  • 21. Hypothesis It is hypothesized individuals with stages 3 or 4 chronic kidney disease who consume a Renal Failure Diet over a 6 month period will be significantly more likely to have their chronic kidney disease enter remission than individuals with stage 3 or 4 chronic kidney disease who do not modify their diets. It is further hypothesized that individuals with stage 3 or 4 chronic kidney disease who consume an renal failure diet over a 6 month period will be significantly less likely to require dialysis treatment than individuals with stage 3 or 4 chronic kidney disease who do not modify their diets. 21
  • 25. Materials Renal Blood – 10 Outpatient Assessment Failure Testing Medical Dialysis Materials Diet Foods Equipment Doctors Facility
  • 26. Procedures  Diagnosis of Type I Diabetes and participants with stage 3 or 4 Chronic Kidney Disease. Experimental participants receive a week’s worth of Renal Failure Diet frozen meals from the Outpatient Dialysis Center weekly.  Control participants will maintain their regular diet; which will consist of all food being:  Broiled  Grilled  Baked 26 www.kidney.niddk.nih.gov
  • 27. Procedures Cont.  Participants will be asked to eat meals at a set times. 7 am Breakfast 11 am Lunch  2:30pm Snack 6 pm Dinner  Time Frame 6 month period  Assessments to determine the necessity of dialysis treatment
  • 28. References American Diabetes Association, (2007); Diabetes, Retrieved on August 12, 2010, from www.diabetes.org Brighthub Health (2008); Health and Diabetes, Retrieved on August 25, 2010; from; www.brighthub.com/health/diabetes/articles/2749/apsx Center for Disease Control, (2007); What is diabetes, Retrieved on August 12, 2010, from www.cdc.gov/diabetes/consumers/learn.htm eMedicine for WebMD, (2009); Development of Type I Diabetes; Retrieved from http://emedicine.medscape.com
  • 29. References Merck Manuals, (2010); Online Medical Library, Long-Term Complications Diabetes; Retrieved on August 19, 2010, from www.merck.com/mmhe National Kidney and Urologic Disease Information Clearinghouse, (2010); Kidney Disease, Retrieved from, www.kidney.niddk.nih.gov National Kidney Foundation, (2008); Kidney Disease and Diabetes, Retrieved on August 19, 2010, from www.kidney.org